Health and Prognosis Not Taken Into Account When Treating Older People with Lung Cancer

In a study of people 65 and older with non-small cell lung cancer, younger people were more likely to receive treatment than older ones, regardless of overall health and prognosis.

The study, published in the Jour­nal of Clinical Oncology, found that treatment rates decreased more in association with advancing age than with the worsening of other illnesses. People between the ages of 65 and 74 who were severely ill from other illnesses, and thus less likely to benefit and more likely to be harmed from cancer treatment, received treatment at roughly the same rate as those in the same age range with no comorbidities. They were more likely to receive treat­ment than those between 75 and 84 with no comorbidities and much better prognoses.

“The message here is, don’t base cancer treatment strictly on age.”

“It’s clear that as human beings and physicians, we fixate on age in deciding whether to pursue cancer treatments, including lung cancer treatments,” says lead author Sunny Wang, md, a San Francisco VA Medical Center physician and an assistant clinical professor of medi­cine at the University of California, San Francisco. “Instead, we should be looking at our patients’ overall state of health.”

The authors cite previous research indicating that older people with non-small cell lung cancer who are otherwise healthy can benefit from treatment, while those with comor­bidities are more vulnerable to the toxicity of cancer treatments and less likely to complete a course
of treatment.

“The message here is, don’t base cancer treatment strictly on age,” says Dr. Wang. “Don’t write off an otherwise healthy 75 year old, and don’t automatically decide to treat a really ill 65 year old without care­fully assessing the risks and benefits for that patient.”

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This article was published in Coping® with Cancer magazine,
May/June
2012.